Provider Demographics
NPI:1295802866
Name:BENYAMMI, FELLA (DDS)
Entity type:Individual
Prefix:DR
First Name:FELLA
Middle Name:
Last Name:BENYAMMI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SOUTH DRIVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4317
Mailing Address - Country:US
Mailing Address - Phone:650-254-1596
Mailing Address - Fax:650-254-0738
Practice Address - Street 1:105 SOUTH DRIVE
Practice Address - Street 2:SUITE 140
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4317
Practice Address - Country:US
Practice Address - Phone:650-254-1596
Practice Address - Fax:650-254-0738
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice